Molecular epidemiology of noroviruses in children under 5 years of age with acute gastroenteritis in Yaoundé, Cameroon

Norovirus is a common cause of acute gastroenteritis (AGE) among children in developing countries. Limited data on the prevalence and genetic variability of norovirus are available in Cameroon, where early childhood mortality due to AGE is common. We tested 902 fecal specimens from children younger than 5 years of age hospitalized with AGE between January 2010 and December 2013. Overall, 76 (8.4%) samples tested positive for norovirus, of which 83% (63/76) were among children below 12 months old. Most of the noroviruses detected were in children infected between July and December of each year. All norovirus-positive specimens were genotyped, with 80% (61/76) being GII.4 (three variants detected). Genotypes GI.2, GI.6, GII.1, GII.2, GII.3, GII.6, GII.16, GII.17, and GII.21 were also detected. Interestingly, GII.4 Sydney and GII.17 Kawasaki viruses were found as early as 2010, years before their emergence globally. This study suggests norovirus is a significant cause of moderate to severe gastroenteritis among young children in Cameroon. The results are important to highlight appropriate prevention and control strategies for reducing the burden of norovirus disease.

Phenotypic characterization of human pathogenic bacteria in fish from the coastal waters of South West Cameroon: public health implications

Increasing economic and recreational opportunities, attractive scenery and a perception of a better quality of life are luring people to the coast. Unfortunately, these activities together with the commensurate increase in population in the area inevitably result in pollution of coastal waters with excessive microorganisms and other pollutants. Microbial pollutants not only contaminate the coastal water but also aquatic food sources, thus posing a health risk to consumers. Fish is a major source of protein in Cameroon, especially in the coastal areas. In this study, we investigated the microbiological quality of fish from the Limbe and Tiko beaches in South West Cameroon from May to October 2007. We isolated human pathogenic bacteria from three anatomic sites (skin, gills, intestine) of 50 fish (150 specimens) and investigated their susceptibility patterns to a battery of antibiotics. Data were analyzed statistically using chi2 with significance set at p < .05. Eleven bacterial species were identified, including Escherichia coli type 1 (20.8%), Citrobacter fruendii (16.4%), Proteus vulgaris (13%), Klebsiella pneumoniae (12.1%), Klebsiella ozaenae (7.7%), Enterobacter cloacae (7.2%), Klebsiella oxytoca (5.8%), Serratia marcescens (4.8%), Serratia odorifera (4.8%), Hafnia alvei (4.4%) and Proteus penneri (2.9%). More contaminated fish were found at Limbe beach than at Tiko beach (61.4% versus 38.6%, respectively (p < .05)). When ranking contamination with respect to anatomic site, skin was the most contaminated (40.6%) specimen and gills the least (28.5%). Ciprofloxacillin, ofloxacillin, and cotrimoxazole were the most effective antibiotics against all isolates, exhibiting 100% sensitivity. Almost half of the isolates (45.7%) were resistant to ampicillin. The results of our study demonstrate that fish from the coastal waters of South West Cameroon are a source of human pathogenic and opportunistic bacteria; hence this finding has public health implications.

Antimicrobial resistance of bacterial agents of the upper respiratory tract of school children in Buea, Cameroon

The study was aimed at determining bacterial agents of the upper respiratory tract and the susceptibility patterns of isolates to antibiotics. In total, 200 throat swabs were obtained from students attending different boarding schools within the Buea Municipality and screened to obtain the prevalence of respiratory pathogens and to understand the antibiotic susceptibility patterns of isolates using standard microbiological procedure and the disc-diffusion test. Of the 200 samples screened, 112 (56%) had positive cultures with the dominant bacterial pathogens being Haemophilus influenzae (20%), followed by Streptococcus pneumoniae (15%), Klebsiella pneumoniae (11%), and Staphylococcus aureus (10%). Although 56% of the isolates were recovered from females compared to 44% from males, the difference was not statistically significant (p>0.05). Sixty-seven percent of the pathogens were isolated from the age-group of 10-13 years, 19.6% from the age-group of 14-17 years, and 12.5% from the age-group of 18-21 years. Antibiotic susceptibility testing revealed that gentamicin (92%) and cefuroxime (88.4%) were the most effective antibiotics against the isolates. Generally, susceptibility ranged from 0% to 92% depending on the antibiotic and the species of microorganism. Penicillin had the highest (100%) resistance to all the isolates. The findings revealed that students living in boarding schools in the Buea Municipality were at risk of acquiring upper respiratory tract infections from their peers since the upper respiratory tract of more than 50% of the students was colonized with respiratory pathogens. Although multidrug-resistant strains of organisms were identified, gentamicin and cefuroxime are recommended as the first-line antibiotics of choice against the pathogens. There is, therefore, a need for surveillance of nasopharyngeal carriage of resistant strains of these organisms, especially H. influenzae in unhealthy school children since the vaccine is yet to be introduced in Cameroon. The findings have clinical and epidemiological significance.

Bacterial indicators of pollution of the Douala lagoon, Cameroon: public health implications

BACKGROUND

Indiscriminate disposal of untreated wastes which are often heavily laden with sewage microorganisms some of which are pathogenic to humans into aquatic environments near cities could serve as potential dangers to human health.

OBJECTIVE

A prospective study was undertaken to investigate the scope of potential bacterial pathogens and to assess the extent of pollution of the Douala lagoon.

METHODS

A total of eighty water samples were collected fortnightly from the lagoon at five stations from March to October 2005 and analysed for heterotrophic bacterial densities, coliform counts, faecal coliform and faecal streptococcal counts. Bacteria were isolated and identified using standard microbiology and biochemical techniques.

RESULTS

High heterotrophic bacterial counts (33 x 10(5) - 161 x 10(5) CFU/ mL), total coliform counts (1.8 x 10(2) - 2.4 x 10(2) CFU/100 mL), faecal coliform counts (2.2 x 10(2) - 2.4 x 10(2) CFU/ 100 mL) and faecal streptococcal counts (2.1 x 102 - 2.3 x 10(2) CFU/100mL were observed in all sampling stations. Eleven species of bacteria: Bacteroides fragilis, Proteus vulgaris, Klebsiella pneumoniae, E. coli, Enterococcus faecalis, Enterobacter aerogenes, Citrobacter freundii, Aeromonas hydrophila, Pseudomonas aeruginosa, Bacillus mycoides and Serratia marcesens, were frequently isolated.

CONCLUSION

The presence of potential bacterial agents such as Bacteroides fragilis, Pseudomonas aeruginosa, Aeromonas hydrophila, Klebsiella pneumoniae and E. coli in the lagoon may pose a serious threat to the health and well being of users of the Lagoon and calls for urgent intervention.

Helicobacter pylori isolates recovered from gastric biopsies of patients with gastro-duodenal pathologies in Cameroon: current status of antibiogram

OBJECTIVE

To determine the prevalence of Helicobacter pylori in patients with gastro-duodenal pathologies and the susceptibility patterns of isolates to the currently recommended antibiotic treatment regimen used in Cameroon.

METHODS

Consecutive dyspeptic patients referred to Douala General Hospital, Cameroon for endoscopy were recruited in the study. Gastric biopsies were collected from the patients and H. pylori isolated and identified following standard microbiology and biochemical techniques. Antibiotic susceptibility was determined by disk diffusion and agar dilution methods against clarithromycin, tetracycline, amoxicillin and metronidazole. Data were analysed using chi-square test and significance considered at P < 0.05.

RESULTS

Seventy-one (92.2%) of the 77 patients (mean age 44.5 +/- 15.7, range 15-77 years) were positive for H. pylori. The antibiotic susceptibility rates were 56% for tetracycline, 55.3% for clarithromycin, 14.4% for amoxicillin and 6.8% for metronidazole. The prevalence of clarithromycin resistance in males vs. females was 42.1%vs. 46.7%, while for metronidazole it was 89.5%vs. 94.7% (P > 0.05). Antimicrobial susceptibility results also revealed 12 antibiotypes based on resistance to the antimicrobial agents investigated. The resistance pattern, amoxicillin and metronidazole (AMR(R) MET(R)) was the most common (23.7%) amongst the isolates. More than 60% of the isolates exhibited multi-drug resistance to three or four antibiotics.

CONCLUSION

Multi-drug resistance is common against the current treatment regimen in Cameroon and, therefore, calls for urgent studies involving newer and broad spectrum antibiotics to address the problem.

In-vitro antimicrobial activity of selected honeys on clinical isolates of Helicobacter pylori

BACKGROUND

Helicobacter pylori is a gram-negative bacterium incriminated in gastroduodenal ulcers, and mucosa-associated lymphoid tissue lymphoma imposing a major burden on health care systems worldwide. Honeys have been shown to have in vitro activity against microorganisms and suitable for use in ulcers, infected wounds and burns.

OBJECTIVE

The study was aimed at evaluating the antimicrobial potential of honeys (Manuka™, Capillano®, Eco- and Mountain) at different concentrations (10%v/v, 20%v/v, 50%v/v and 75%v/v) against clinical isolates of H. pylori.

METHODS

H. pylori was isolated from gastric biopsies of patients with gastroduodenal pathologies following standard microbiological procedures. Antimicrobial susceptibility of the isolates to different honey varieties was determined by the disk diffusion assay. Also, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the most potent honey was determined by the agar dilution method. Data were analysed using the Fisher exact test and statistical significance considered at p<0.05.

RESULTS

All the four honey varieties exhibited antibacterial activity. The strongest inhibitory activity (82.22%) was demonstrated by Mountain honey at 75%v/v, followed by Capillano® and Manuka™ honeys (75.56%), and Eco-honey (73.36%) at the same concentration. However, no statistically significant difference (p>0.05) was noted between the honeys at different concentrations. The MIC and MBC concentrations of Mountain honey were in the range 0.117 - 0.938ì/mL and 0.366 - 2.965ìg/mL respectively. The antimicrobial potential of these honeys at different concentrations were highly comparable to clarithromycin, the positive control.

CONCLUSION

These honeys may contain compounds with therapeutic potential against our local isolates of H. pylori.

Antibacterial effect of Zingiber officinale and Garcinia kola on respiratory tract pathogens

OBJECTIVE

To investigate the antibacterial activity of Zingiber officinale (ginger) Garcinia kola (bitter kola) on four respiratory tract pathogens.

DESIGN

A prospective study based on laboratory investigations.

SETTING

Department of Life Sciences, University of Buea. Throat swabs were collected from 333 individuals with running nostrils, cough and/or catarrh in three localities of Buea namely Bokwango, Molyko and Bolifamba. Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae and Haemophilus influenzae were isolated from the specimens using standard microbiological procedures. The antibacterial activity of ethanolic extracts of ginger and bitter kola, were investigated on these pathogens using the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) assays.

RESULTS

The extracts exhibited antibacterial activity against the pathogens. The MIC of extracts ranged from 0.0003 microg/ml to 0.7 microg/ml for ginger and 0.00008 microg/ml, to 1.8 microg/mL for bitter kola, while MBC ranged from 0.1.35 microg/ml to 2.04 microg/ml for ginger and 0.135 microg/ml to 4.2 microg/ml for bitter kola.

CONCLUSION

Results indicated that extracts of ginger root and bitter kola may contain compounds with therapeutic activity.

Carriage of Vibrio species by shrimps harvested from the coastal waters of South West Cameroon

OBJECTIVES

To determine the prevalence of Vibrio spp in unprocessed shrimps and their susceptibility to antibiotics.

DESIGN

A prospective study of Vibrio spp associated with shrimps harvested from the coastal waters of South West Cameroon.

SETTING

A laboratory based study at the Department of Life Sciences, University of Buea. Two hundred and thirty six shrimps harvested from the coastal towns of Limbe and Tiko, Cameroon, were examined for the prevalence of Vibrio spp using standard microbiologic procedures. The antibiotic sensitivity of isolates was determined using the Kirby-Bauer disc diffusion technique.

RESULTS

Of the 236 shrimps examined, 73 (30.9%) were contaminated with Vibrio spp. Further, a total of 125 Vibrio strains were isolated from the contaminated shrimps. Of this number, 33 (26.4%) were V. cholerae, 55 (44%) V. parahaemolyticus, 34 (27.2%) V. alginolyticus and three (2.4%) V. vulnificus. Antibiotic susceptibility generally ranged from 68.8% for polymyxin B to 99.2% for gentamycin. Multiple resistant strains were noted, especially with V. parahaemolyticus and V. alginolyticus

CONCLUSION

Shrimps maintain a reservoir of potential Vibrio spp in the coastal area of South West Cameroon. This finding is of epidemiologic and clinical significance.